<div class="panel-wrap" style="height: auto">	
	<div class="panel-header-div">PIC (Person In Charge)</div>
	<div class="panel-body-div" style="height: 960px">
		<div class="left-panel-body">
			<div class="form">
				<div class="fields">
					<div class="field">
						<div class="label">
							<label for="name_owner">Nama:</label>
						</div>
						<div class="input">
							<input type="text" maxlength="30" id="pic_name" name="pic_name" value="<?=$pic_name?>" class="medium" style="background-color:LightGray" readonly="readonly" />
						</div>
					</div>	
					<div class="field">
						<div class="label">
							<label for="building">Alamat:</label>
						</div>
						<div class="input">
							<textarea maxlength="255" rows="3" name="pic_address" style="background-color:LightGray" readonly="readonly" ><?=$pic_address?></textarea>
						</div>
					</div>
					<div class="field">
						<div class="label">
							<label for="area">Kota:</label>
						</div>
						<div class="input">
							<input type="text" maxlength="50" name="pic_city" value="<?=$pic_city?>" class="medium" style="background-color:LightGray" readonly="readonly"  />
						</div>
					</div>
					<div class="field">
						<div class="label">
							<label for="area">Provinsi:</label>
						</div>
						<div class="input">
                            <input type="text" value="<?=$data['province']['member_display'][$pic_province-1]?>" style="background-color:LightGray" readonly="readonly"  />
						</div>
					</div>
					<div class="field">
						<div class="label">
							<label for="area">Kode Pos:</label>
						</div>
						<div class="input">
							<input type="text" maxlength="10" name="pic_zip_code" value="<?=$pic_zip_code?>" class="medium" style="background-color:LightGray" readonly="readonly"  />
						</div>
					</div>
					<div class="field">
						<div class="label">
							<label for="area">Nomor Telepon:</label>
						</div>
						<div class="input">
							<input type="text" maxlength="20" id="pic_phone_no" name="pic_phone_no" value="<?=$pic_phone?>" class="medium" style="background-color:LightGray" readonly="readonly" />
						</div>
					</div>
					<div class="field">
						<div class="label">
							<label for="identity_type">Tipe Identitas:</label>
						</div>
						<div class="input">
                            <input type="text" value="<?=$pic_identity_type?>" style="background-color:LightGray" readonly="readonly" />
						
						</div>
					</div>
					<div class="field">
						<div class="label">
							<label for="area">Nomor Kartu Identitas:</label>
						</div>
						<div class="input">
							<input type="text" maxlength="30" name="pic_identity_no" value="<?=$pic_identity_no?>" class="medium" style="background-color:LightGray" readonly="readonly"  />
						</div>
					</div>
					<div class="field">
						<div class="label">
							<label for="birth_owner">Tempat Lahir:</label>
						</div>
						<div class="input">
							<input type="text" maxlength="50" name="pic_birth_place" value="<?=$pic_birth_place?>" class="medium" style="background-color:LightGray" readonly="readonly" />
						</div>
					</div>
					<div class="field">
						<div class="label">
							<label for="slash">Tanggal Lahir:</label>
						</div>
						<div class="input">
							<input type="text"  name="pic_birth_date" value="<?=$pic_birth_date?>" class="medium" style="background-color:LightGray" readonly="readonly" />
						</div>
					</div>
					
					<div class="field">
						<div class="label">
							<label for="area">Posisi:</label>
						</div>
						<div class="input">
							<input type="text" maxlength="50" name="pic_job_position" value="<?=$pic_job_position?>" class="medium" style="background-color:LightGray" readonly="readonly"  />
						</div>
					</div>
					
					<div class="field">
						<div class="label">
							<label for="area">Nomor Telepon (Smartfren):</label>
						</div>
						<div class="input">
							<input type="text" maxlength="20" name="smartfren_no" value="<?=$pic_smartfren_no?>" class="medium" style="background-color:LightGray" readonly="readonly"  />
						</div>
					</div>
					
					<div class="field">
						<div class="label">
							<label for="area">Nomor Ponsel (Lainnya):</label>
						</div>
						<div class="input">
							<input type="text" maxlength="20" name="mobile_no" value="<?=$pic_mobile_no?>" class="medium" style="background-color:LightGray" readonly="readonly"  />
						</div>
					</div>
					<div class="field">
						<div class="label">
							<label for="area">Email:</label>
						</div>
						<div class="input">
							<input type="text" maxlength="50" name="pic_email" value="<?=$pic_email?>" class="medium" style="background-color:LightGray" readonly="readonly"  />
						</div>
					</div>

				</div>
			</div>
		</div>
	</div>
</div>

<script>
	$(function() {
		$( "#datepick" ).datepick({
			yearRange: '1950:2050'
		});
		
		$("#date_image").click(function(){
			$("#datepick").datepick("show");
		});	
	});
	
	function fillPIC()
	{
		var pic_name = document.getElementById( "pic_name" ).value;
		var pic_phone = document.getElementById( "pic_phone_no" ).value;
		
		document.getElementById( "pic_name_agent" ).value = pic_name;
		document.getElementById( "pic_phone_agent" ).value = pic_phone;
	}
</script>